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The available interventions for androgenic alopecia (AGA), the most common type of hair loss worldwide, remain limited. The insulin growth factor (IGF) system may play an important role in the pathogenesis of AGA. However, the exact role of IGF binding protein-related protein 1 (IGFBP-rP1) in hair growth and AGA has not been reported. In this study, we first found periodic variation in IGFBP-rP1 during the hair cycle transition in murine hair follicles (HFs). We further demonstrated that IGFBP-rP1 levels were lower in the serum and scalp HFs of individuals with AGA than in those of healthy controls. Subsequently, we verified that IGFBP-rP1 had no cytotoxicity to human outer root sheath cells (HORSCs) and that IGFBP-rP1 reversed the inhibitory effects of DHT on the migration of HORSCs in vitro. Finally, a DHT-induced AGA mouse model was created. The results revealed that the expression of IGFBP-rP1 in murine HFs was downregulated after DHT treatment and that subcutaneous injection of IGFBP-rP1 delayed catagen occurrence and prolonged the anagen phase of HFs in mice with DHT-induced AGA. The present work shows that IGFBP-rP1 is involved in hair cycle transition and exhibits great therapeutic potential for AGA.
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Alopecia , Proteínas de Ligação a Fator de Crescimento Semelhante a Insulina , Humanos , Camundongos , Animais , Proteínas de Ligação a Fator de Crescimento Semelhante a Insulina/farmacologia , Alopecia/tratamento farmacológico , Folículo PilosoRESUMO
BACKGROUND: The association between remnant cholesterol (RC) and diabetic retinopathy (DR) in type 2 diabetes mellitus (T2DM) remains unclear. Morphological changes in retinal vessels have been reported to predict vascular complications of diabetes, including DR. METHODS: This cross-sectional study included 6535 individuals with T2DM. The RC value was calculated using the recognized formula. The retinal vascular parameters were measured using fundus photography. The independent relationship between RC and DR was analyzed using binary logistic regression models. Multiple linear regression and subgroup analyses were employed to investigate the link between RC and vascular parameters, including the retinal arteriolar diameter (CRAE), venular diameter (CRVE), and fractal dimension (Df). Mediation analysis was performed to assess whether the vascular morphology could explain the association between RC and DR. RESULTS: RC was independently associated with DR in patients with a longer duration of T2DM (> 7 years). Patients with the highest quartile RC levels had larger CRAE (5.559 [4.093, 7.025] µm), CRVE (7.620 [5.298, 9.941] µm) and Df (0.013 [0.009, 0.017]) compared with patients with the lowest quartile RC levels. Results were robust across different subgroups. The association between RC and DR was mediated by CRVE (0.020 ± 0.005; 95% confidence interval: 0.012-0.032). CONCLUSIONS: RC may be a risk factor for DR among those who have had T2DM for a longer period of time. Higher RC levels were correlated with wider retinal arterioles and venules as well as higher Df, and it may contribute to DR through the dilation of retinal venules.
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Diabetes Mellitus Tipo 2 , Retinopatia Diabética , Humanos , Diabetes Mellitus Tipo 2/complicações , Retinopatia Diabética/complicações , Estudos Transversais , Fatores de Risco , Vasos Retinianos/diagnóstico por imagem , ColesterolRESUMO
Objective: The IKZF4(Ikaros family zinc finger 4) gene encodes Eos, a zinc finger transcription factor that belongs to the Ikaros family. High expression of Eos on Treg cells is important for the suppression of autoimmune responses and immune homeostasis. It has been suggested that the SNP in IKZF4 may influence the pathogenesis of AA(alopecia areata). The purpose of this study was to explore the relationship between IKZF4 polymorphism and AA in the Chinese Han population. Methods: We examined 459 patients and 434 controls in this study. The rs1701704 polymorphism was evaluated using HRM analysis and direct sequencing. Results: The prevalence of the C/C, A/C, and A/A genotypes in AA patients was 7.4%, 37.5% and 55.1%, respectively. There were significant differences in genotype distribution and allele frequencies between AA and the control group (P < .0001). The frequency of the C allele in the AA group was significantly higher (P < .0001), and the frequencies of the C allele and C/C genotype in patients with family history were higher (P < .0001; P = .001). Conclusions: The rs1701704 SNP of IKZF4 may be a genetic marker for assessing the risk of AA in the Chinese Han population.
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BACKGROUND: Quarantine due to the COVID-19 pandemic may have created great psychological stress among vulnerable populations. We aimed to investigate the prevalence of anxiety and explore the association between physical activities (PA) and anxiety risk in people with non-communicable diseases during the period of COVID-19 lockdown. METHODS: We conducted a cross-sectional telephone survey from February 25 to April 20, 2020, the period of COVID-19 lockdown in Shanghai. Up to 8000 patients with type 2 diabetes and/or hypertension were selected using multi-stage cluster random sampling. PA level was measured based on the International Physical Activity Questionnaire using Metabolic Equivalent for Task scores, while symptoms of anxiety were assessed by the 7-item Generalized Anxiety Disorder scale. Multiple logistic regression analyses were performed to evaluate the associations of type and level of PA with the risk of anxiety. RESULTS: Of a total 4877 eligible patients, 2602 (53.4%) reported with anxiety, and 2463 (50.5%), 123 (2.5%) and 16 (0.3%) reported with mild, moderate, and severe anxiety. The prevalence of anxiety was higher in the females, the elders, non-smokers, non-drinkers, and patients with diabetes, and the associations of anxiety with sex, age, smoking, drinking and diagnosis of diabetes were significant. A significant negative association was observed for housework activities (OR 0.53, 95%CI: [0.45, 0.63], p < 0.001) and trip activities (OR 0.55, 95%CI: [0.48, 0.63], p < 0.001) with anxiety, but no significant was found for exercise activities (OR 1.06, 95%CI: [0.94, 1.20], p = 0.321). Compared with patients with a low PA level, those with a moderate (OR 0.53, 95%CI: [0.44, 0.64], p < 0.001) or a high PA level (OR 0.51, 95%CI: [0.43, 0.51], p < 0.001) had a lower prevalence of anxiety. CONCLUSION: This study demonstrates a higher prevalence of anxiety in patients with hypertension, diabetes, or both during the COVID-19 lockdown. The negative associations of housework and trip activities with anxiety highlight the potential benefit of PA among patients with non-communicable diseases.
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COVID-19 , Diabetes Mellitus Tipo 2 , Doenças não Transmissíveis , Feminino , Humanos , Idoso , COVID-19/epidemiologia , Estudos Transversais , Diabetes Mellitus Tipo 2/epidemiologia , SARS-CoV-2 , Prevalência , Pandemias , Doenças não Transmissíveis/epidemiologia , Depressão/epidemiologia , China/epidemiologia , Controle de Doenças Transmissíveis , Ansiedade/epidemiologia , Ansiedade/diagnóstico , Exercício FísicoRESUMO
BACKGROUND: COVID-19 lockdowns may lead to physical inactivity, a major risk factor for non-communicable diseases. This study aims to determine: 1) the trajectory in daily step counts before, during and after the lockdown in China, and 2) the characteristics associated with the trajectories. METHODS: From December 2019 to July 2020, smartphone-based step counts were continuously collected in 815 Chinese adults residing in Shanghai over 202 days across three phases: before, during, and after the lockdown. Participant characteristics were reported, and height, weight and body composition measured before the lockdown. A 'sharp' regression discontinuity design with cluster robust standard errors was used to test the effect of the lockdown and reopening on daily steps and a linear mixed model was used to examine the characteristics associated with trajectories during the observed period. RESULTS: Based on 164,630 person-days of data, we found a sharp decline in daily step counts upon the lockdown (24/01/2020) by an average of 3796 (SE = 88) steps, followed by a significant trend of increase by 34 steps/day (SE = 2.5; p < .001) until the end of the lockdown (22/03/2020). This increasing trend continued into the reopening phase at a slower rate of 5 steps per day (SE = 2.3; p = 0.029). Those who were older, married, university educated, insufficiently active, had an 'at risk' body composition, and those in the control group, were slower at recovering step counts during the lockdown, and those who were older, married, without university education and with an 'at risk' body composition recovered step counts at a slower pace after the reopening. CONCLUSIONS: Despite later increases in step counts, COVID-19 lockdown led to a sustained period of reduced physical activity, which may have adverse health implications. Governments and health professionals around the world should continue to encourage and facilitate physical activity during the pandemic.
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COVID-19/prevenção & controle , Coleta de Dados/estatística & dados numéricos , Exercício Físico , Monitores de Aptidão Física , Aplicativos Móveis , Comportamento Sedentário , Adulto , China/epidemiologia , Controle de Doenças Transmissíveis/métodos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , SARS-CoV-2 , SmartphoneRESUMO
BACKGROUND: Adults with chronic conditions such as heart disease, diabetes, or lung disease are more likely to develop complications from a number of vaccine-preventable diseases, including influenza and pneumonia. In this study, we use the data from a chronic disease management information system in Shanghai to estimate vaccination coverage and characterize predictors of seasonal influenza and 23-valent pneumococcal polysaccharide vaccine (PPSV23) vaccination among people with chronic disease in Shanghai. METHODS: The Shanghai Centers for Disease Control and Prevention have information systems related to chronic disease management, hospital records, and immunizations. Data from individuals with hypertension, diabetes and chronic obstructive pulmonary disease (COPD) were abstracted during July 2017. The main outcome was coverage of pneumococcal and influenza vaccination. Vaccination coverage was calculated across demographic groups. Significance in bivariate associations was assessed through Pearson's chi-square tests, and in multivariable models through logistic regression models with a forward stepwise method to select variables. RESULTS: In the sample of 2,531,227 individuals ≥15 years, 22.8% were vaccinated for pneumonia from January 2013 to July 2017, and the vaccination coverage of influenza in the 2016/17 influenza season was 0.4%. Vaccination coverage was highest in those 70-79 and lowest in those younger than 60. Compared to urban areas, uptake in rural areas was higher for pneumonia vaccination (OR: 2.43, 95% CI: 2.41, 2.45), but lower for influenza vaccination (OR: 0.55, 95% CI: 0.51, 0.59). Having a greater number of chronic diseases was associated with higher likelihood of pneumonia vaccination (3 vs 1: OR: 1.68, 95% CI: 1.64, 1.71), but this relationship was not statistically significant for influenza vaccination. CONCLUSIONS: We found low levels with of pneumococcal vaccination, and extremely low uptake of influenza vaccination among individuals with high risk conditions in Shanghai who should be priority groups targeted for vaccination. Interventions could be designed to target groups with low uptake - like younger adults, and individuals who have not yet retired.
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Doença Crônica/epidemiologia , Vacinas contra Influenza/administração & dosagem , Vacinas Pneumocócicas/administração & dosagem , Cobertura Vacinal/estatística & dados numéricos , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , China/epidemiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Adulto JovemRESUMO
BACKGROUND: Long noncoding RNAs (lncRNAs) regulate gene expression by acting with microRNAs (miRNAs) and indirectly interact with messenger RNA (mRNAs). However, the roles of specific lncRNA and its related competing endogenous RNAs (ceRNA) network in alopecia areata (AA) are not fully understood. METHODS: The blood lncRNA profiles were obtained by microarray from 10 samples, including five alopecia areata samples and five normal samples. Based on bioinformatics generated from miRcode, starBase, and miRTarBase, we constructed an lncRNA-miRNA-mRNA network (ceRNA network) in alopecia areata. RESULTS: We found 154 differentially expressed lncRNAs and 46 differentially expressed genes (DEGs). The functional enrichment indicated that the DEGs mainly regulated the pathways of focal adhesion, Mucin type O-glycan biosynthesis, and so on. The differentially expressed lncRNA (DElncRNA) involved in the pathway of thyronamine and iodothyronamine metabolism and so on. Through integrated lncRNA-mRNA and miRNA-mRNA pairs, the ceRNA network was constructed, thereafter, six ceRNA subnetworks were identified and subnetwork 1 were found to be significantly associated with the occurrence of alopecia areata. CONCLUSION: Our results showed blood lncRNA expression patterns and a complex ceRNA network in alopecia areata. However, futher studies on blood and tissue verification of these lncRNAs and relative pathways are needed.
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Alopecia em Áreas/genética , Redes Reguladoras de Genes , MicroRNAs/genética , RNA Longo não Codificante/genética , RNA Mensageiro/genética , Alopecia em Áreas/sangue , Alopecia em Áreas/fisiopatologia , Estudos de Casos e Controles , Biologia Computacional/métodos , Adesões Focais/genética , Perfilação da Expressão Gênica , Regulação da Expressão Gênica , Ontologia Genética , Humanos , MicroRNAs/sangue , MicroRNAs/classificação , Análise em Microsséries , Anotação de Sequência Molecular , RNA Longo não Codificante/sangue , RNA Longo não Codificante/classificação , RNA Mensageiro/sangue , RNA Mensageiro/classificação , Tironinas/metabolismoRESUMO
BACKGROUND: Alopecia areata (AA) is a common inflammatory disease characterized by cellular infiltration of T cells targeting the anagen-stage hair follicle. Lack of efficacious treatment for AA may be due to little knowledge about its exact cellular mechanism. Studies have demonstrated that microRNAs (miRNAs) play an important role in the regulation of inflammatory skin diseases such as atopic dermatitis and psoriasis. However, little is known about the role of miRNAs in AA. OBJECTIVE: The present study aimed to explore the blood miRNAs alterations in patients with severe active AA. METHODS: We constructed a bipartite miRNA-messenger RNA (mRNA) regulatory network by the validated miRNA-mRNA relationships. Subsequently, the miRNA-miRNA synergistic network was formed in consideration of the Gene Ontology function enrichment of coregulated target genes. Lastly, the functional network was identified by the ingenuity pathway analysis. RESULTS: By using an Agilent microarray that covers 2549 human miRNAs, we identified 36 significantly differentially expressed miRNAs in severe active AA patients. miRNA target gene prediction and functional annotation analysis showed significant enrichment in several pathways including the ribosome, cancer, cell cycle, insulin signaling, transforming growth factor-ßsignaling, and p53 signaling pathways. Analysis of the three kinds of network showed that miR-185-5p, miR-125b-5p, and miR-186-5p might play important and synergistic roles in the active phase of AA. According to the receiver operating characteristic curve analysis, several miRNAs were selected for the quantitative real-time polymerase chain reaction validation. Among the miRNAs, miR-210 and miR-1246 had high prediction with high accuracy. CONCLUSION: Blood dysregulated miRNAs are potentially associated with the severe active AA. These miRNAs could function synergistically and might be promising targets for the development of novel treatments for AA in the future.
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Alopecia em Áreas/genética , Perfilação da Expressão Gênica/métodos , Redes Reguladoras de Genes , MicroRNAs/genética , Adulto , Alopecia em Áreas/sangue , Alopecia em Áreas/patologia , Feminino , Ontologia Genética , Humanos , Masculino , MicroRNAs/sangue , Pessoa de Meia-Idade , Índice de Gravidade de DoençaAssuntos
Sistema ABO de Grupos Sanguíneos , Alelos , Povo Asiático , Fucosiltransferases , Galactosídeo 2-alfa-L-Fucosiltransferase , Fenótipo , Humanos , Fucosiltransferases/genética , Povo Asiático/genética , Sistema ABO de Grupos Sanguíneos/genética , China , Masculino , Feminino , População do Leste AsiáticoRESUMO
OBJECTIVE: To investigate the association of CAG repeat numbers in the androgen receptor (AR) gene with female pattern hair loss (FPHL) in a Chinese population. METHODS: A total of 200 Han Chinese patients with FPHL (142 Ludwig II and 58 Ludwig III cases) and 200 healthy controls were enrolled in this study. The polymorphism of CAG repeat numbers was analyzed by the fluorescent amplified fragment length polymorphism technique. RESULTS: The CAG biallelic mean length was 23.73 ± 2.04 repeats in Han Chinese FPHL patients and 23.90 ± 2.13 repeats in healthy controls, without any significant difference between the two groups (p = 0.481). In addition, neither the shorter nor the longer CAG repeat numbers were significantly different between FPHL and control subjects (p = 0.726, p = 0.383). CONCLUSION: The polymorphism of CAG repeat numbers of the AR gene may not be the genetic marker of FPHL in a Chinese population.
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Alopecia/genética , Polimorfismo Genético , Receptores Androgênicos/genética , Adulto , Alopecia/epidemiologia , Alopecia/metabolismo , Análise do Polimorfismo de Comprimento de Fragmentos Amplificados , China/epidemiologia , Cromossomos Humanos X/genética , Primers do DNA/genética , Feminino , Humanos , Incidência , Repetições Minissatélites , Receptores Androgênicos/metabolismoRESUMO
Finasteride at 1 mg/day and 5% topical minoxidil are effective in male androgenetic alopecia (MAGA). However, studies describing their effects in Chinese individuals are scarce. 450 Chinese MAGA patients were randomly assigned to receive finasteride (n = 160), minoxidil (n = 130) and combined medication (n = 160) for 12 months. The patients returned to the clinic every 3 months for efficacy evaluation. And efficacy was evaluated in 428 men at treatment end, including 154, 122, and 152 in the finasteride, 5% minoxidil, and combination groups, respectively. All groups showed similar baseline characteristics, including age at enrollment, and duration and severity of alopecia (p > 0.05). At 12 months, 80.5, 59, and 94.1% men treated with finasteride, 5% minoxidil and the combination therapy showed improvement, respectively. Adverse reactions were rare (finasteride, 1.8%; minoxidil, 6.1%), and disappeared right after drug withdrawal. In conclusion, finasteride is superior to 5% minoxidil, while the combined medication showed the best efficacy.
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Alopecia/tratamento farmacológico , Finasterida/administração & dosagem , Minoxidil/administração & dosagem , Inibidores de 5-alfa Redutase/administração & dosagem , Inibidores de 5-alfa Redutase/efeitos adversos , Administração Oral , Administração Tópica , Adolescente , Adulto , Povo Asiático , China , Quimioterapia Combinada , Finasterida/efeitos adversos , Humanos , Masculino , Pessoa de Meia-Idade , Minoxidil/efeitos adversos , Resultado do Tratamento , Vasodilatadores/administração & dosagem , Vasodilatadores/efeitos adversos , Adulto JovemRESUMO
BACKGROUND: It has been suggested that the single nucleotide polymorphism (SNP) of the CYP19A1 gene encoding aromatase may affect the development of female pattern hair loss (FPHL). OBJECTIVE: Our aim was to investigate the association of CYP19A1 gene SNPs with FPHL in a Chinese population. METHODS: Two hundred Chinese Han patients with FPHL and 200 controls were enrolled into our study. SNaPshot technology was used to detect CYP19A1 gene candidate SNPs. RESULTS: The allele frequencies and distributions of rs6493497 and rs7176005 were significantly different between FPHL and control subjects (p < 0.001 and p < 0.001 vs. p < 0.001 and p = 0.003). CONCLUSION: The rs6493497 and rs7176005 SNPs of the CYP19A1 gene may be genetic markers that influence the risk of FPHL in this Chinese population.
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Aromatase/genética , DNA/genética , Polimorfismo de Nucleotídeo Único , Vigilância da População/métodos , Adulto , Alopecia/epidemiologia , Alopecia/genética , Alopecia/metabolismo , Aromatase/metabolismo , China/epidemiologia , Feminino , Frequência do Gene , Marcadores Genéticos , Genótipo , Haplótipos , Humanos , Incidência , Reação em Cadeia da PolimeraseRESUMO
Alopecia areata (AA) is a common chronic hair condition that has negative impact on both patients and their families. The aim of this article is to assess the impact of AA on patients' quality of life (QoL) using the dermatology life quality index (DLQI) questionnaire, and assess its feasibility and internal consistency. A cross-sectional survey was conducted among 831 patients with AA between January 2010 and July 2012. The Chinese version of DLQI questionnaire was used to assess the QoL of AA patients more than 16 years old. About 698 patients (84%) completed the questionnaire. The scores ranged from 0 to 29 with a mean of 5.8 ± 5.6. Patients' QoL was affected moderately to extremely by AA. Questions 2 (embarrassment), 5(social or entertainment), and 3 (shopping or housework) had the most impact on patients. Mean score of younger patients was higher compared to older ones (6.2 vs. 4.8, P < .05). Patients with alopecia totalis/alopecia universalis, longer duration, local symptoms, and recurrent disease exhibited higher scores (P < .001). Among our patients with AA, Cronbach's alpha was .881, indicating high internal reliability of DLQI questionnaire. In conclusion, AA moderately affected the QoL of the patients. These individuals had to be treated early, and required psychological support in addition to prescription drugs.
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Alopecia em Áreas/psicologia , Qualidade de Vida , Adolescente , Adulto , China/epidemiologia , Estudos Transversais , Feminino , Humanos , Masculino , Qualidade de Vida/psicologia , Inquéritos e Questionários , Adulto JovemRESUMO
OBJECTIVE: To investigate the relationship between homocysteine (HCY) and androgenetic alopecia (AGA). METHODS: A case control study and two observational experiments on mice were conducted. In the first part, a total of 528 Chinese AGA patients and 500 age-matched healthy controls were included. Serum HCY levels of AGA and controls were compared. In the second part, eight mice were divided into two groups. Both groups of mice had their hair removed. AGA group received a DHT injection, and the other as control group. HCY levels in hair follicles (HFs) were detected by ELISA and compared. In the third part, twelve mice were divided into three groups and fed with different concentrations of methionine. After 4 weeks, serum HCY levels, parameters related to hair growth through observation and HE staining, and expression of immunohistochemistry (IHC) hair-growth-related markers Ki67, VEGF, IGF-1, Krt27, FGF9, and TGF-ß1 were compared among the three groups. RESULTS: In the first part, HCY levels were higher in AGA than the controls of both genders. However, there was no difference in HCY levels between groups with varying severity. Rates of hyperhomocysteinemia was higher in AGA patients than the controls. Logistic regression analysis showed serum HCY levels was positively correlated with the incidence of AGA. In the second part, HCY of the HFs in the AGA group was significantly higher than that in the control group. The third part showed that the increase in serum HCY levels inhibited the growth of mice hair, with the less expressed stimulative markers Ki67, VEGF, IGF-1, Krt27, and FGF9, while there was no difference in the expression of inhibitory markers TGF-ß1. CONCLUSION: There is a potential relationship between HCY and AGA. HCY had an inhibitory effect on hair growth. Further studies are necessary to explore the specific mechanism.
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Bacterial biofilm formation is associated with the pathogenicity of pathogens and poses a serious threat to human health and clinical therapy. Complex biofilm structures provide physical barriers that inhibit antibiotic penetration and inactivate antibiotics via enzymatic breakdown. The development of biofilm-disrupting nanoparticles offers a promising strategy for combating biofilm infections. Hence, polyethyleneimine surface-modified silver-selenium nanocomposites, Ag@Se@PEI (ASP NCs), were designed for synergistic antibacterial effects by destroying bacterial biofilms to promote wound healing. The results ofin vitroantimicrobial experiments showed that, ASP NCs achieved efficient antibacterial effects againstStaphylococcus aureus (S. aureus)andEscherichia coli (E. coli)by disrupting the formation of the bacterial biofilm, stimulating the outbreak of reactive oxygen species and destroying the integrity of bacterial cell membranes. Thein-vivobacterial infection in mice model showed that, ASP NCs further promoted wound healing and new tissue formation by reducing inflammatory factors and promoting collagen fiber formation which efficiently enhanced the antibacterial effect. Overall, ASP NCs possess low toxicity and minimal side effects, coupled with biocompatibility and efficient antibacterial properties. By disrupting biofilms and bacterial cell membranes, ASP NCs reduced inflammatory responses and accelerated the healing of infected wounds. This nanocomposite-based study offers new insights into antibacterial therapeutic strategies as potential alternatives to antibiotics for wound healing.
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Antibacterianos , Biofilmes , Escherichia coli , Nanocompostos , Polietilenoimina , Selênio , Prata , Staphylococcus aureus , Cicatrização , Biofilmes/efeitos dos fármacos , Animais , Nanocompostos/química , Prata/química , Camundongos , Polietilenoimina/química , Cicatrização/efeitos dos fármacos , Staphylococcus aureus/efeitos dos fármacos , Selênio/química , Selênio/farmacologia , Antibacterianos/farmacologia , Antibacterianos/química , Escherichia coli/efeitos dos fármacos , Espécies Reativas de Oxigênio/metabolismo , Humanos , Testes de Sensibilidade Microbiana , Nanopartículas Metálicas/química , Infecção dos Ferimentos/tratamento farmacológico , Infecção dos Ferimentos/microbiologia , Anti-Infecciosos/farmacologia , Anti-Infecciosos/química , MasculinoRESUMO
We investigated the control rate of hypertension across months of year and hours of day in a real-world database. The study participants were hypertensive patients from 142 community health centers across 16 districts in Shanghai, China, who measured their blood pressure with an automatic office blood pressure measurement platform between 2018 and 2023. The 343,400 hypertensive patients included 53.7% of women, and had average age of 70.2 (±8.1) years (range 50-90 years). For months of year, the control rate of hypertension was lowest in February and highest in August (51.9% vs 71.8%). For hours of day, the control rate of hypertension was lowest at 7:00 AM and highest at 12:00 PM (52.1% vs 76.0%). When the months of year and hour of day were considered together, the control rate was lowest at 7 AM in February (42.1%), and highest at 12 PM in July (86.8%). In 8516 patients who had uncontrolled blood pressure in the early morning and had their blood pressure also measured around noon, 45.7% had masked uncontrolled morning hypertension, with higher rates in spring and summer, and in women, those aged 50-69 years, and non-diabetic patients. The control rate of hypertension varies greatly across months of year and hours of day, suggesting that the evaluation of blood pressure control has to take into full consideration the measurement time in terms of months and hours.
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To practice standardized office blood pressure (OBP) measurement guidelines pragmatically, we developed an intelligent assisted OBP (IOBP) measurement system in the Chinese community, which can automatically obtain two or three BP values after a 5-min rest before the patients visit the doctor and transfer values to the community medical network in real time. We conducted a comparative study to investigate the agreement among IOBP, awake ambulatory BP (ABP), and conventional auscultatory OBP at different BP levels. Participants were divided into three groups according to BP, with 120/80 mmHg and 160/100 mmHg as the cut-off points. Attended IOBP, unattended IOBP, and auscultatory OBP were randomly measured before ABP monitoring. In total, 245 participants were included in the analysis. The mean systolic attended/unattended IOBP, auscultatory OBP, and awake ABP were 135.0, 136.7, 135.6, and 136.2 mmHg, respectively. Bland-Altman analysis revealed a bias of -1.1 and 0.5 mmHg for systolic attended/unattended IOBP compared with awake ABP in the overall sample. For auscultatory OBP, the bias was -0.4 (attended) and 1.2 mmHg (unattended). The discrepancy between the systolic attended/unattended IOBP and awake ABP was inconsistent at different BP levels. In Group 1 the values were -8.4 and -6.9 mmHg, whereas in Group 3, the values were 9.4 and 10.0 mmHg. BP measured using the IOBP measurement system was in accordance with awake ABP and conventional OBP, and can be a good choice in the Chinese community.
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Determinação da Pressão Arterial , Monitorização Ambulatorial da Pressão Arterial , Pressão Sanguínea , Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Adulto , Monitorização Ambulatorial da Pressão Arterial/métodos , Idoso , Determinação da Pressão Arterial/métodos , Pressão Sanguínea/fisiologia , China , Auscultação , Hipertensão/diagnóstico , Hipertensão/fisiopatologia , Vigília/fisiologia , População do Leste AsiáticoRESUMO
Artificial intelligence (AI) telephone is reliable for the follow-up and management of hypertensives. It takes less time and is equivalent to manual follow-up to a high degree. We conducted a reliability study to evaluate the efficiency of AI telephone follow-up in the management of hypertension. During May 18 and June 30, 2020, 350 hypertensives managed by the Pengpu Community Health Service Center in Shanghai were recruited for follow-up, once by AI and once by a human. The second follow-up was conducted within 3-7 days (mean 5.5 days). The mean length time of two calls were compared by paired t-test, and Cohen's Kappa coefficient was used to evaluate the reliability of the results between the two follow-up visits. The mean length time of AI calls was shorter (4.15 min) than that of manual calls (5.24 min, P < .001). The answers related to the symptoms showed moderate to substantial consistency (κ:.465-.624, P < .001), and those related to the complications showed fair consistency (κ:.349, P < .001). In terms of lifestyle, the answer related to smoking showed a very high consistency (κ:.915, P < .001), while those addressing salt consumption, alcohol consumption, and exercise showed moderate to substantial consistency (κ:.402-.645, P < .001). There was moderate consistency in regular usage of medication (κ:.484, P < .001).
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Inteligência Artificial , Hipertensão , Telefone , Humanos , Hipertensão/tratamento farmacológico , Hipertensão/diagnóstico , Hipertensão/epidemiologia , Feminino , Masculino , Pessoa de Meia-Idade , Reprodutibilidade dos Testes , China/epidemiologia , Seguimentos , Idoso , AdultoRESUMO
BACKGROUND: Actinic keratosis (AK) is prevalent and has been widely studied in fair-skinned populations. However, this is not the case in eastern countries. AK in Asians has not been so thoroughly investigated. OBJECTIVES: To analyse the clinical and pathological features of a relatively large number of cases of AK diagnosed in older Chinese patients. METHODS: Case histories of 328 patients with pathologically diagnosed AK were analysed retrospectively. Their demographic, clinical, pathological and treatment data were collected for analysis of associated factors. RESULTS: Lesions were usually distributed on the face, especially the cheeks and temples. The most frequent pathological type was hypertrophic. Only 34% of the cases had been diagnosed correctly as AK before biopsy; many were mistaken for seborrhoeic keratosis. CONCLUSIONS: Most patients were elderly females and there was a higher incidence of lesions on the face, and a lower incidence on the extremities and trunk; this finding contrasts with previous investigations in fair-skinned people.
Assuntos
Povo Asiático , Erros de Diagnóstico , Dermatoses Faciais/patologia , Ceratose Actínica/patologia , Pele/patologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Animais , Biópsia , China , Feminino , Humanos , Hipertrofia/patologia , Ceratose Actínica/diagnóstico , Ceratose Actínica/terapia , Extremidade Inferior , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Tronco , Extremidade SuperiorRESUMO
BACKGROUND: We found microRNA (miR)-1246 to be significantly differentially expressed between severe active alopecia areata (AA) patients and healthy individuals. OBJECTIVE: To explore the role and mechanism of miR-1246 in severe AA. METHODS: Expression of miR-1246, dual-specific tyrosine phosphorylation-regulated kinase 1A (DYRK1A), and nuclear factor of activated T cells 1c (NFATc1) in peripheral CD4+ T cells and in scalp tissues of patients were detected using RT-qPCR, Western blot, and immunohistochemistry assays. Peripheral CD4+ T cells from the AA patients were transfected with lentiviral vectors overexpressing miR-1246. RT-qPCR and Western blot analysis were used to measure mRNA or protein expression of retinoic-acid-receptor-related orphan nuclear receptor gamma (ROR-γt), interleukin (IL)-17, DYRK1A, NFATc1, and phosphorylated NFATc1. Flow cytometry was used to assay the CD4+IL-17+ cells proportion. ELISA was used to measure cytokine levels. RESULTS: miR-1246 levels decreased and DYRK1A and NFATc1 mRNA levels significantly increased in the peripheral CD4+ T cells and scalp tissues of severe active AA samples. NFATc1 protein expression was also significantly increased in the peripheral CD4+ T cells but not in the scalp tissues. NFATc1 positive cells were mainly distributed among infiltrating inflammatory cells around hair follicles. In peripheral CD4+ T cells of severe active AA, overexpression of miR-1246 resulted in significant downregulation of DYRK1A, NFATc1, ROR-γt, and IL-17 mRNA and phosphorylated NFATc1 protein, as well as a decrease in the CD4+IL-17+ cells proportion and the IL-17F level. CONCLUSION: miR-1246 can inhibit NFAT signaling and Th17 cell activation, which may be beneficial in the severe AA treatment.